NaphCare Illegally Practiced Medicine in New York and Failed to Provide Adequate Care at Onondaga County Jail Company Barred from Providing Jail Health Services in New York for Five Years and Must Pay $875,000 New York Attorney General Letitia James today announced a settlement with correctional health care provider NaphCare, LLC (NaphCare) and its affiliate Proactive Health Care Medicine, PLLC (Proactive), following an investigation into three deaths at the Onondaga County Justice Center (OCJC) in Syracuse. The Office of the Attorney General (OAG) found that NaphCare illegally practiced medicine in New York and broadly controlled medical decisions at OCJC despite not being licensed to provide medical services in the state. As a result of the investigation, NaphCare must pay $875,000 to the state and is barred from contracting to provide health services in any New York state or local correctional facility for five years.
“Every New Yorker deserves safe and competent medical care,” said Attorney General James. “Our investigation found that NaphCare illegally practiced medicine in New York and failed to adequately protect individuals in custody who relied on their care. These failures put vulnerable individuals at serious risk and had devastating consequences. Today, we are holding NaphCare accountable and ensuring it cannot return to New York without strict oversight.”
NaphCare is a private, for-profit correctional health care company based in Alabama that provided medical services at OCJC, the Onondaga County Correctional Facility, and the Hillbrook Juvenile Detention Center between 2020 and 2022. The OAG launched an investigation following reports of multiple deaths in custody potentially attributable to inadequate medical care. Through the investigation, OAG determined that NaphCare had created Proactive, a New York corporation, to serve as the nominal medical provider for incarcerated individuals in Onondaga County facilities while continuing to illegally handle decision-making and oversight from Alabama.
When entering into contracts with correctional facilities, NaphCare and Proactive claimed that Proactive would provide all clinical care, while NaphCare would provide only administrative and management services. However, the OAG found that NaphCare employees in Alabama regularly issued treatment orders, prescribed medications, and directed care for incarcerated patients in New York. NaphCare also exercised significant control over Proactive’s operations and supervised its medical staff, effectively running the entire medical practice at the facilities despite not being licensed to practice medicine in New York.
The OAG investigation also uncovered serious failures in care during NaphCare’s tenure at OCJC. Within a roughly 20-month period, three people in custody died after receiving inadequate medical attention. One incarcerated pregnant woman, who was given no prenatal care, repeatedly reported that her water had broken and that she was in labor, but was not evaluated by a medical provider for more than 30 hours and was not transported to a hospital until after she gave birth alone in her cell. Her premature newborn died hours later. Another person died by suicide after not receiving necessary mental health care. A third person, a man in his sixties with a known history of hypertension and other medical conditions, died from cardiovascular disease after receiving only intermittent treatment for dangerously high blood pressure and after multiple medication errors, including mix-ups in ordering and administering his prescriptions.
The OAG learned that many treatment decisions during these incidents were made remotely through NaphCare’s electronic communication system, which allowed providers in Alabama to review electronic records and issue orders without seeing or speaking to patients. Ultimately, OAG determined that NaphCare engaged in repeated and persistent illegal practices, including widespread violations of New York’s corporate practice of medicine laws, which prohibit non-medical corporations from owning medical practices and from directly employing physicians to provide medical care in the state. The OAG also found that NaphCare violated numerous state regulations governing medical care in correctional facilities and repeatedly failed to follow its own policies and procedures, as well as national standards for correctional health care.
As a result of OAG’s investigation, NaphCare must pay $875,000 in penalties and is prohibited from bidding on or entering into any contracts with New York state or any New York municipality to provide correctional health services for five years. For an additional five years after that, NaphCare must provide advance notice to OAG and receive written approval before entering into any such contract. If the company is ever permitted to provide correctional health services in New York again, any providers delivering medical, dental, or mental health care to patients in the state, including through telehealth, must be employed by or contracted through a properly licensed New York professional medical entity. If NaphCare fails to uphold any terms of the agreement, it will face a $50,000 penalty for each violation and may face additional enforcement action.
New York Attorney General Letitia James today announced a settlement with correctional health care provider NaphCare, LLC (NaphCare) and its affiliate Proactive Health Care Medicine, PLLC (Proactive), following an investigation into three deaths at the Onondaga County Justice Center (OCJC) in Syracuse. The Office of the Attorney General (OAG) found that NaphCare illegally practiced medicine in New York and broadly controlled medical decisions at OCJC despite not being licensed to provide medical services in the state. As a result of the investigation, NaphCare must pay $875,000 to the state and is barred from contracting to provide health services in any New York state or local correctional facility for five years.
“Every New Yorker deserves safe and competent medical care,” said Attorney General James. “Our investigation found that NaphCare illegally practiced medicine in New York and failed to adequately protect individuals in custody who relied on their care. These failures put vulnerable individuals at serious risk and had devastating consequences. Today, we are holding NaphCare accountable and ensuring it cannot return to New York without strict oversight.”
NaphCare is a private, for-profit correctional health care company based in Alabama that provided medical services at OCJC, the Onondaga County Correctional Facility, and the Hillbrook Juvenile Detention Center between 2020 and 2022. The OAG launched an investigation following reports of multiple deaths in custody potentially attributable to inadequate medical care. Through the investigation, OAG determined that NaphCare had created Proactive, a New York corporation, to serve as the nominal medical provider for incarcerated individuals in Onondaga County facilities while continuing to illegally handle decision-making and oversight from Alabama.
When entering into contracts with correctional facilities, NaphCare and Proactive claimed that Proactive would provide all clinical care, while NaphCare would provide only administrative and management services. However, the OAG found that NaphCare employees in Alabama regularly issued treatment orders, prescribed medications, and directed care for incarcerated patients in New York. NaphCare also exercised significant control over Proactive’s operations and supervised its medical staff, effectively running the entire medical practice at the facilities despite not being licensed to practice medicine in New York.
The OAG investigation also uncovered serious failures in care during NaphCare’s tenure at OCJC. Within a roughly 20-month period, three people in custody died after receiving inadequate medical attention. One incarcerated pregnant woman, who was given no prenatal care, repeatedly reported that her water had broken and that she was in labor, but was not evaluated by a medical provider for more than 30 hours and was not transported to a hospital until after she gave birth alone in her cell. Her premature newborn died hours later. Another person died by suicide after not receiving necessary mental health care. A third person, a man in his sixties with a known history of hypertension and other medical conditions, died from cardiovascular disease after receiving only intermittent treatment for dangerously high blood pressure and after multiple medication errors, including mix-ups in ordering and administering his prescriptions.
The OAG learned that many treatment decisions during these incidents were made remotely through NaphCare’s electronic communication system, which allowed providers in Alabama to review electronic records and issue orders without seeing or speaking to patients. Ultimately, OAG determined that NaphCare engaged in repeated and persistent illegal practices, including widespread violations of New York’s corporate practice of medicine laws, which prohibit non-medical corporations from owning medical practices and from directly employing physicians to provide medical care in the state. The OAG also found that NaphCare violated numerous state regulations governing medical care in correctional facilities and repeatedly failed to follow its own policies and procedures, as well as national standards for correctional health care.
As a result of OAG’s investigation, NaphCare must pay $875,000 in penalties and is prohibited from bidding on or entering into any contracts with New York state or any New York municipality to provide correctional health services for five years. For an additional five years after that, NaphCare must provide advance notice to OAG and receive written approval before entering into any such contract. If the company is ever permitted to provide correctional health services in New York again, any providers delivering medical, dental, or mental health care to patients in the state, including through telehealth, must be employed by or contracted through a properly licensed New York professional medical entity. If NaphCare fails to uphold any terms of the agreement, it will face a $50,000 penalty for each violation and may face additional enforcement action.
